Brittney Burns – Staff Writer

Macon County Commissioner Ronnie Beale spoke to members of his board and the Southwestern Community College Board of Trustees about the devastating news that as of July, Angel Medical Center will no longer be delivering babies.

“We are shocked,” said Commissioner Beale. “I know they have been delivering babies in that hospital for 61 years because I was one of them. Not having that service in our community for our residents will be absolutely devastating. It’s going to be devastating for our health care system, for our young people trying to start families, and for our economy here in Macon County.

Angel Medical Center (AMC), a not-for-profit Critical Access Hospital announced Tuesday plans to modify its OB/GYN program with the goal of sustaining women’s health services and hospital services in Macon County. AMC will discontinue labor and delivery services but will continue to provide pre- and post-natal services, gynecological services, surgical procedures as well as preventive, routine and complex care for women of all ages.

Beale said that although both parties claim the decision was mutual, neither the community nor county leaders weren’t included in the loop. Macon County Commission Chairman Jim Tate couldn’t hide his frustration when speaking on the issue Tuesday.

“I will tell you what I told them when they called me and I told them they could quote me on it,” he said. “I am completely blindsided. We are all completely blindsided. We had no idea this was coming and would have appreciated some sort of a heads up that this type of conversation was even being had. We had no idea.”

Beale expressed concerns about forcing Macon County residents to travel for a type of care that really cannot wait.

“Mission Hospital is a long way to travel when you are about to have a baby,” said Beale. “The closest hospital to us now would be Sylva, and they aren’t affiliated with Mission Hospital so I don’t even know how that would work.”

Macon County Economic Development Director Tommy Jenkins said that he too was in the dark about the changes to the hospital and from an economic development perspective, believes the change will be devastating for new business and growth.

“When people are considering coming here to live or start a business, one of the first thing they ask is about our health care,” said Jenkins. “Our focus to revitalize our economy has been to bill Macon County as an attractive community for young entrepreneurs, many of which who are in the process of starting families. Without a hospital able to provide that, it is going to be difficult to do.”

AMC is in the process of exploring several options for transitioning these services to Mission Hospital in Asheville, where according to a press release from Mission Health, a quarter of all Macon, Jackson and Swain county women already choose to deliver their babies, or alternatively to DLP Harris Hospital in Sylva. A final plan will be in place before June, and July 14, 2017, will be the last date for labor and delivery component of Women’s Services at Angel Medical Center.

Discontinuing labor and deliver services at AMC is just one of the changes Mission Hospital is working on. While the Women’s Unit is set to drastically change in July, Mission Hospital is working to finalize plans to completely rebuild the hospital, investing more than $40 million to construct a new facility.

“Mission Health is contemplating significant, new investments totaling as much as $46 million for a newly built hospital and upgrades to existing facilities based upon a detailed analysis of our population, broad healthcare delivery trends and pending health policy changes. As part of that plan, we will be transitioning labor and delivery services from Angel Medical Center, looking to identify the optimal approach that reflects women’s existing choices and that will benefit our families in Franklin,” said Karen Gorby, RN, President and CNO, Angel Medical Center. “Our final decision will ensure that we have excellent labor and delivery services for our moms and babies combined with full-time, local pre- and post-natal care, gynecology services and other women’s health services in Franklin. We will share more information on the details of the transition of labor and delivery services in the coming weeks,” said Gorby.

The decision to discontinue labor and delivery services was made after an extensive analysis of AMC’s Women’s and Children’s services. Based on an assessment of the medical center’s clinical services, OB-GYN and pediatric practice stability and fiscal sustainability, AMC and Mission Health determined that discontinuing labor and delivery services at AMC is the responsible decision for the sustainable future of Macon County’s community health, wellness and inpatient services.

Just last year, Mission Hospital was touting the expansion of Women’s Services at AMC and were planning a more than $4 million expansion of the unit to accommodate the growing needs. In a Macon County News report on the expansion project published in June 2016, Mission had secured a projected budget for the project of $4.3 million to “allow the facility to accommodate the increasing number of births in the region.”

The plan was to expand the facility to feature nine postpartum rooms and four labor and delivery recovery rooms. The expansion was also supposed to include adding one ADA-compliant Labor/Delivery/Recovery room, four ADA-compliant postpartum patient rooms, and relocating and expanding three bassinet nurseries. The project also included non-clinical renovations which includes adding a central nurse and physician station for the women’s unit, adding staff and unit support facilities, and expanding the public waiting areas.

Mission Hospital’s announcement to discontinue labor and deliver did not include any explanation as to why in a year’s time their plans went from expanding the unit to meet a growing need, to discontinue the program entirely.

The Macon County community was just as blindsided by the news, with many taking to social media to voice their frustration, sharing their own stories of delivering at the hospital.

“The news that Angel Medical Center is discontinuing labor and delivery services in Franklin is absolutely ridiculous,” said Andrew Foley. “When my daughter was born there May 4, 2014, Angel treated my wife like a queen and everything went great. Angel Medical Center is making a huge mistake and hope they reconsider discontinuing these services and putting many Macon County nurses out of work. The only good thing about Angel Medical Center is now gone.”

“For 68 hours I laid in the hospital bed to bring a beautiful life into this world,” said Diamond Burch, “All of my nurses talked about how wonderful I was to still be so upbeat and in a good mood, but what I failed to tell them because at the time I didn’t realize that If it hadn’t been for such an amazing team of nurses, day and night shift, I probably would have went crazy. It was an honor to meet all of them and it saddens me that if we decide to have another that I won’t have that same amazing team.”

Other residents called on local officials to rally to prevent the change from happening.

“It has taken years for the residents of Macon County to have local quality care,” said Kristen Nicole. “Women and babies need the labor and delivery. There are more rural areas where these women come to Franklin for quality health care and to deliver their babies … some of these women live hours from Sylva and Asheville. Franklin is their closest quality option. Are babies going to start being born in the ER? Not to mention transport…is EMS going to be tied up transporting women in labor to the other hospitals? Then when car accidents, illnesses at home, etc. and our people call for EMS — true emergencies … are they going to have to wait for EMS to get back from taking women to Mission or Sylva? This idea is not going to be financially feasible in the long run. Who is going to pay for all this extra transport? What is going to be done with the empty beds in the [labor and delivery] unit? Our population is growing not only from people relocating here, but from more of the newest members of our community being born locally. Hospital resources in the ED are tied up with dealing with mental health/substance abuse patients. Why not consider contracting more medical help for the jails and for transportation in getting the MH/SA patients to Park Ridge or other facilities equipped to deal with them? Our elected officials and citizens need to rally together and fight against removing [labor and delivery] from Angel.”

Representative Kevin Corbin weighed in on the decision late Wednesday.

“I strongly oppose this decision and action,” Rep. Corbin said. “When you have a great service being provided that is serving your community, that service should not be discontinued. This was a decision made because of the lack of profitability of a service. Mission should see the larger picture of their profitability of serving the entire community and not singling out this sector for exclusion.”

Residents who had experienced complicated pregnancies spoke to how devastating a more than 30-minute drive could be for a mother in labor and having the needed care close could often be the difference between life and death.

“With my first child in 2012 I went into the hospital and was quickly evaluated and diagnosed with a life threatening condition called HELLP,” said Aimee Holbrook. “Had I not been seen and diagnosed so quickly by the very knowledgeable staff my life and my son’s life could have been lost. These type conditions need to be addressed as  soon as possible. There isn’t always a warning they can come on very quickly. Therefore a drive 30 minutes or even an hour extra could be fatal. The doctors and nurses in the labor and delivery department were incredible and go over and above for their patients. I also delivered a son in 2015 and having been there before they knew my history were prepared for my delivery thankfully this one was HELLP free. To sum it up, minutes even seconds matter when it comes to labor and delivery.”

The trickle down impact of eliminating the services was another point local residents noted as being a reason to not change the current services.

“The decision made by Mission health systems to eliminate the mother and baby unit at Angel Medical Center is truly infuriating,” said Maddy Brown. “The devastation this will cause to our community can not be calculated. Not only will dozens of hard working people lose their jobs, their families will directly suffer. ER staff will be directly affected by the event, as well as patients of any medical emergency who arrive at the ER expecting care. Staff will now have to be responsible for all emergency OB situations that come through those doors, without any form of immediate support by the appropriate staff or equipment. In no way am I suggesting Angel ER staff is under par in their skills, I have worked hand in hand with dozens of nurses, CNAs and physicians in that ER who are skilled at their jobs. The ER staff is exactly that, an ER staff. They are not centrally trained on the care of high risk pregnancies, or even routine pregnancies that can go wrong in an instant. … What about the local 911 EMS services? Has mission health considered the burden that will place on them? After years of begging, a mission health transfer truck has now been placed in Macon County to assist in transports – just in time for mission health to indirectly advise them through their actions that ‘sorry, all women of child bearing age, paired with abdominal pain with the potential of pregnancy and or OB complications, will have to be transported to an appropriate facility considering we robbed yours.’ Nevermind the time it takes for the proper team to be gathered to transport a sick new born and mother – or even a healthy new born and mother who may need further evaluation. Absolutely appalling. Thank you Mission Health for negatively impacting our community in ways you never even considered.”